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NRSG 258 PATHO > Pulmonary Alterations > Flashcards

Pulmonary Alterations Flashcards

1
Q

hypovent

A

dec alveolar vent in relation to demand

min vol dec

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2
Q

hypervent

A 
ventil> demand
inc ph (repir alkal), dec po2 and pco2 (hypoxemia/ hypocapnia)
results- tissue ischem, coma, organ dysfunct
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3
Q

hypercapnia

A

inc CO2 in CSF
inc rate/ depth respir
dec pH (inc respir r)
causes- respir. acidosis/ depression nervo system, disease of medulla or spinal cord injury
results- cerbral vasodil = inc intracranial P

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4
Q

hypoxemia

A

dec O2 in blood
act. chemorecep
< 60 mmHg

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5
Q

O2Hb affinity- L and R shift

A 
ph- inc= inc affinity (lungs)
dec= dec aff (tissues)
temp- inc = dec aff tissue uploading
dec= inc aff- lung oxygenation
left shift= inc aff 
right shift= dec aff (O2 released)
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6
Q

hemoptysis

A

blood stained sputum

frm lungs, trach, larynx, bronchi

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7
Q

orthopnea

A

difficulty breathing when laying down

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8
Q

Kussmahl breathing

A

deep and labored, assoc w/ ketoacid. and renal failure

“hypervent”

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9
Q

ventilation perfusion inequality or mismatch

A

v/q
air in alveoli/ blood flow in cap
normal = 0.8-0.9

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10
Q

shunting

A

low v/q, dec vent to well perfused areas

results- dec o2 sat, dyspnea

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11
Q

alveolar dead space

A

high v/q, poor perfusion
cause- inc residual co2
inhaled air not participate in gas exchange= alv damage

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12
Q

hypoxemia

A

not enough o2 avaliable

cause- abnorm v/q, inc mem thickness, edema, dec surface area

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13
Q

zone 1 of lungs

A

alve P> arterial and venous

apex

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14
Q

zone 2 of lungs

A

arterial P > alveo P

venous P < alveo P

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15
Q

zone 3 of lungs

A

base

alveol P < arterial and venous P

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16
Q

acute respir failure

A

causes- lung / chest wall injury, spinal cord/ brain injury, pulm diseases, surgical complicat
inadeq gas exchange
po2> 50 mmHg= dec alveol vent
po2< 50 mmHg= dec exchan between alveol and cap

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17
Q

pleural effusion

A

fluid in pleural space (increases alvel. P but no collapse)
results- dyspnea, pleural pain (differen from chest wall pain w/ palpation!), compression atelectasis (lung collapse), muffled lung sounds

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18
Q

transductive effusion

A

(systemic)
from left heart failure
fluid comes from capil into pleural space

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19
Q

exudative (local)

A

from infection
fluid inc wbc and protein in pleural space
cause- infection, inflamm, cancer

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20
Q

hemothorax

A

blood in pleural cavity

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21
Q

empyema

A

pus in pleural space

common cause- pneumonia

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22
Q

pneumothorax

A

collection gas in pleural cav
results- atelectasis
symptoms- dependant on size, pain and speed

23
Q

primary pneumothorax

A

occurs idopathically

24
Q

pneumothorax- secondary

A

due to underlying dis.

25
Q

pneumothorax-open

A

air in w/ inspiration, forced out w/ expir.
“sucking wound”
opening in chest wall

26
Q

pneumothorax- closed

A

no hole in chest wall

secondary

27
Q

charac of restrictive lung dis

A

dec lung compliance
inc effort expand lungs during inspir
inc respir r and dec tidal vol
ex- pulm fibrosis or pulm edema

28
Q

charact of obstructive lung dis

A 
air obstruction worsens w/ expriation
inc effort during expir
symptoms- dyspnea and wheezing
ex.- emphysema and asthma
dec FEV forced expiratory vol
results- v/q mismatch, respir failure, cor pulmonae
29
Q

pulm edema

A

excess fluid in lungs
restrictive
causes- L sided heart failure, toxic gas inhal, ARDS
results- dyspnea, inc effort breathing, inspir crackles, hypoxemia, pink frothy sputum

30
Q

acute respir distress syndrome (full) ARDS

A

restrictive
alveolar injury
causes- trauma, sepsis
treatment- mechanical vent
progession- hypervent, respir alkalosis, dyspnea, metab acidosis, repir acidosis, hypoxemia, hypotension, dec cardiac o, death
treatment- maintain o2 and vent, prevent infection, steroids, supportive therapy

31
Q

classic ards-manifes

A

dyspnea, inspir crackles, dec lung complian, hypoxemia (unrespon to suppor. O2) respir alkalosis

32
Q

progessive ARDS- manifes

A

dec tissue perfu, organ dysfun, metab acidosis, inc effort breathing, dec tidal vol, hypovent, respir acidosis, hyoxemia, hypotension, dec cardiac O, death

33
Q

COPD chronic obstructive pulmon disease

A

obstructive
inc inflam, dec elasticity
air trapping- bronchial walls collapse (thickens or covered w/ mucus)
v/q mismatch, hypoxemia, alveo collpase

34
Q

chronic bronchitis- criteria and irritants

A

criteria- 3 mon/year and 2 consecut years
hypersecret mucus and chronic productiv cough normal

inc size and number endothelial cells, edema, thickening bronchial walls, impaired cilliary function= inc susceptibility to infection
results- bronchospasms w/ dyspnea

35
Q

chronic bronchitis- manifes, trtment, management

A

treatment- bronchodial, antib
manifest- productive cough, tachypnea, dyspnea, thick secretions, hypoxia, cyanosis, hypercapnia, polycythemia, weight loss
management- education (dec exposure irritants), treat infection, vacc for prophylaxis, expectorants (breakdown mucus), bronchodial (prevent bronchospasms, dec o2 flow

36
Q

emphysema

A

brkdn alveol wall
dec sa for gas exchange, loss pulm cap, loss elasticity, altered v/q
causes- fribrosis
progression- dec expiration = overinflation (air trapping), barrel chest, rib fixation, flattened diaph
progession (advanc)- loss tissue, hypercap, infections, damaged alv = lrg air spaces, pneumothorax (air in pleural cav), weight loss, fatigue, clubbed fingers
treatment- hydration, good nutr, lung reduction surgery

37
Q

asthma

A

obstruc
symptom- dysp, wheezing, tight chest
cause- inflam response, vasodil, cap perm, edema, muscus production, thickened airway, broncial sm musc spasms (hyperresponsiveness)
treatmnt- steroids
results- hypervent, airway obstruct, hypoxemia, dec expiration, respir acidosis

38
Q

asthma atopic v non-atopic

A

atopic caused by allergies

39
Q

laryngotracheobronchitis (CROUP)

A

triggered w/ acute infection upper airway
risk- 6 mon-5yrs, boys, late fall/winter
symptoms- chest wall indrawing, throat swelling, barkin cough, fever
*worse at night
management- cool moist air, corticosteroids, nebulized epinephrine

40
Q

pneumonia

A

lwr respir tract infection
lung inflamm alveol filled w/ fluid (bac, viral, fungi or parasites)
caused- inhal organism, act inflamm response

41
Q

pneumonia- community-acquired

A

viral or bac

affects healthy and immunocomp

42
Q

pneumonia- nosocomial (hospital-acquired)

A

bac gram - Pseudomonas
does not infect healthy ppl
treatment- antib, incentive spir, C+DB cough and deep breath, movement

43
Q

pneumonia- lobar

A 
bac- streptococcus (gram+)
localized or systemic (1+ lobe)
common young adults "walking pneum"
droplet transm = inflamm response
sympt- fever, cough, fatigue
44
Q

pneumonia- fungal

A

risk- immunocomp
caused- Histoplasma capsulatum
id w/ specfic lobe effected

45
Q

pneumonia- parasitic

A

enter through skin or swallowed, travel to lungs
dec o2 transport
attract eosinoph
common antigen- toxoplasma gondii and ascarisis

46
Q

pneumonia- viral

A

common causes- influenza, rsv (repir syncytial virus)
leads to secondary infection
bronchial epith sloughs
manifesti- fever, chills, productive or dry cough, pleural pain, dyspnea, hemoptysis (coughing up blood)

47
Q

tuberculosis

A

antigen- mycobacterium tuberculosis
airborne droplet transm
lodge in upper lobe= act inflam response
symptoms- fever, cough, bloody sputum, weight loss, night sweats
treatment- antib
bac can become dormant = latent infection
dev scar tissue around tubercle (caseous necrosis)

48
Q

pulmonary embolism (PE)

A

bloackage main artery/ branch lung
caused by thrombus or emboli (DVT)
obstruction reaches lungs= inc right vent P
risks- hypercoagulability, endoth vessel wall injury, venous stasis (slow blood flow)
trtmnt- filter into vena cava, mech vent, embolectomy, admin heparin or streptokinase (anticoag)

49
Q

pulmonary embolism (PE)- small emboli

A

manifes- cough, dyspnea, transient chest pain

50
Q

pulmonary embolism (PE)- large emboli

A

inc chest pain, dyspnea, coughing, hempytisis, fever, hypoxia, anxiety, tachyc, restlessness, cyanosis, dec o2, pallor

51
Q

pulmonary embolism (PE)- massive emboli

A

hypotension, severe chest pain, rapid-weak pulse, palpitations, loss of consiousness, shock

52
Q

cystic fibrosis

A

CF
scarring/ cyst formation in pancreas
bc- gene mutation with CFTR
messes w/ sweat, NaCl balance, digestive juices and mucus
risks- caucasian
can be diag before birth
progression- need lung transplant, require protein, diet management (nutrients not absorbed, bc bile not excreted)

53
Q

SIDS sudden infant death syndrome

A

risks- <1yr
peaks at 2-4 month, more common males
usually happens when sleeping
inc risk- immunocomp or those exposed to environ stressors

54
Q

pulmonary system aging

A

dec chest wall compliance and elasticity (recoil)
dec ventilatory reserve
dec SA gas exchange and cap perfusion
dec exercise capacity

NRSG 258 PATHO (3 decks)

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